Attention Section 67 Providers – Members Coverage Inadvertently End-Dated in MIHMS

This notification is to advise Section 67 Nursing Facilities (NFs) that several members have had their MaineCare coverage for nursing facility services inadvertently end-dated on December 31, 2023. We are aware of the issue and a resolution is forthcoming. 

Section 67 providers can continue to bill for nursing facility services up to December 31, 2023 but should refrain from billing for dates of service on or after January 1, 2024.

Attention Nursing Facilities (NFs) and Residential Care Facilities (PNMI, Appendix C, RCFs) – Rates Effective January 1, 2024

Effective January 1, 2024, MaineCare is increasing reimbursement rates for NFs and RCFs in accordance with Part AAAA of P.L. 2021 Ch. 398, to continue to enable providers to cover labor costs for essential support workers to at least 125% of the minimum wage.

Rate letters are posted at the secure Health PAS Online Portal and rates have been implemented for billing.

For questions on rates please contact the individual listed on the rate letter.

Help MaineCare Members Avoid a Gap in Health Coverage

As you may know, changes are coming to MaineCare, and the Maine Department of Health and Human Services is hoping that pharmacies can help to spread the word!

We are working to raise awareness about the need for people with MaineCare to renew their coverage or, if they’re no longer eligible, to enroll in coverage through their employer or through CoverME.gov, Maine’s Health Insurance Marketplace. 

More information about this process can be found at MaineCare.gov/unwinding.

MaineCare for Kids Communications Toolkit

Effective October 1, 2023, the Maine Department of Health and Human Services has expanded eligibility for children and young adults under 21 in Maine to include family incomes up to 300% of the federal poverty level. That translates to an annual salary of about $59,000 for a family of two and $90,000 for a family of four. Additionally, the Department eliminated most premiums for children’s coverage, effective March 1, 2023.

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